Cardiovascular disease in women: The silent enemy

UC Davis cardiologist Amparo Villablanca launched the UC Davis Women's Cardiovascular Medicine Program in 1994.

Heart disease is the leading killer of women in the United States, but it historically has been under-recognized, and surveys of heart-disease knowledge and risk awareness recently conducted by the UC Davis Women's Cardiovascular Medicine Program offer one explanation: Although 98 percent of women know that high blood pressure is a risk factor and 95 percent know that high cholesterol is a risk factor, only 84 percent know that diabetes also is a major risk factor, as well as a growing epidemic.

More significantly, the surveys revealed deeper gaps when it came to women's knowledge of their personal numbers associated with these three risk factors. Only 60, 31 and 24 percent of the women surveyed knew the numbers associated with their own blood pressure, cholesterol and blood sugar, respectively. Still fewer — 9, 19 and 3 percent — knew whether their values for these same three risk factors are normal.

One of seven national model women's heart programs, the UC Davis Women's Cardiovascular Medicine Program conducted the surveys through a grant from the U.S. Department of Health and Human Service.

“Heart disease in women remains under-recognized, underdiagnosed and undertreated,” said Amparo Villablanca, director of the UC Davis Women's Cardiovascular Medicine Program. “Typically, a woman is older than a man when she exhibits symptoms, and they often are more subtle, making detection and diagnosis difficult. As a result, many women fail to receive the needed treatment that could save their lives.”

According to Villablanca, women, more often than men, do not describe chest “pain,” but “discomfort.”

“The discomfort is often not described as the classic 'elephant on my chest,' but as less severe,” Villblanca said. “Also, women more frequently feel some of the associated symptoms of a heart attack, such as dizziness, nausea, fatigue and shortness of breath — with or without chest pain. Lastly, silent heart attacks are more common in women.”

February is American Heart Month, and it serves as an important reminder of the need to address the impact of heart disease on women. The symbol for raising awareness in women is the red dress. The message is clear: Heart disease doesn't care what you wear.

Although many Americans may be aware that heart disease is the leading cause of death in the United States for men, they may not know that heart disease kills more women every year than men. Indeed, although breast cancer has been widely perceived as a woman's most feared enemy, more women in the United States die of heart disease than of all cancers combined.

“The key to reversing this trend lies in raising the awareness of and preventing the risk factors that contribute to heart disease — and increasing awareness of new therapies that can lower the incidence of the disease,” said Villblanca.

Women face two risk factors they cannot control: a family history of heart disease and menopause. However, women can control many risk factors by learning more about their own condition, making lifestyle changes and, in some cases, taking medication. Heart disease is preventable. Villablanca listed these steps women can take to reduce their risk of heart disease:

• Know your numbers for cholesterol, blood pressure, blood sugar and body mass index.
  
  
• Exercise a minimum of 30 minutes a day, every day. A good way to meet this step is to walk 10,000 steps a day.
  
  
• Eat a healthy diet low in saturated fat and cholesterol, and moderate in total fat; choose a variety of grains, especially whole grains; choose a variety of fruits and vegetables daily; choose and prepare foods with less salt; drink alcoholic beverages in moderation.
  
  
• Stop smoking.
  
  
• Know the symptoms and warning signs of a heart attack and stroke.
  
  
• Call 9-1-1 if you experience symptoms of a heart attack or stroke.